Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 8639 | PR |
Y | 208600000X | Surgeon | 8639 | PR |
NPI | 1013996719 |
---|---|
Provider Name | Dr. Julio Enrique Izquierdo-Rivera |
First Address | Mayaguez, PR 00681-1082 |
Second Address | San German, PR 00683 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2006 |
Last Update Date | 14/12/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E20939 | (02) |